eFAST

Undoubtedly, most of you are quite familiar with the concept of an eFAST exam in the setting of thoracoabdominal trauma. eFAST = extended Focused Assessment with Sonography in Trauma. While it’s a standard trauma application, you can utilize its components in other patient scenarios.

During an eFAST exam, you are going to look for free fluid in the pericardium, abdominal cavity or pleural space, and also for a pneumothorax. Any positives will help you expedite definitive care, such as placing a chest tube, calling in an emergent evacuation or taking the patient immediately to the operating room, all within the limitations of your operational environment. Certain negatives, such as presence of bilateral lung sliding (which pretty much excludes pneumothorax) will help you avoid unnecessary interventions.

Whether you start with the subcostal window (recommended) or the RUQ, you should complete the entire exam prior to making further medical decisions. Whatever you do, don’t half-ass the eFAST exam!